Prevalence of Refractive Errors in School Going Children and Associated Risk Factors

Abstract

Background: Refractive errors are a significant cause of vision impairment in school-age children worldwide. This impairment can negatively affect a child’s school performance, social development, and overall quality of life. Particularly in resource-poor environments, early detection and timely interventions can prevent long-term visual impairments and improve educational achievements. 

Objectives: To determine the prevalence of refractive errors among school-aged children and assess associated risk factors, including age, gender, screen time, outdoor activity, family history of eye disease, and existing refractive errors."

Study Design: A cross-sectional study.

Place and duration of study: Department of Ophthalmology, MMC/Bacha Khan Medical College, Mardan, from Jan 2024 to Jan 2025

Methodology: A cross-sectional study was conducted among 100 school-going children aged 6–16 years in urban schools. Visual acuity was assessed using a Snellen chart, followed by objective and subjective refraction. Data on demographics, screen time, outdoor activity, and family history were collected via structured questionnaires. Statistical analysis was performed using SPSS v25.0. Chi-square test and independent t-tests were applied, with p-value <0.05 considered statistically significant.

Results: Among 100 children screened, 28% were diagnosed with refractive errors. The mean age of participants was 11.2 ± 2.7 years. Myopia was the most common type (60.7%), followed by astigmatism (25%) and hyperopia (14.3%). Refractive errors were significantly more prevalent in females (p = 0.034) and in children with increased screen time (>2 hours/day, p = 0.021). A strong association was observed between reduced outdoor activity and the presence of myopia (p = 0.015). Family history of refractive errors was also significantly associated (p = 0.008), suggesting a genetic predisposition. These findings emphasize the multifactorial nature of childhood refractive errors.

Conclusion: the school children examined had refractive errors, the majority of which were myopic. Gender, screen time, outdoor activities, and family history had strong associations. To mitigate the impact of visual impairment, primary interventions such as school vision screenings and early optical interventions should be implemented. School vision screenings, along with parental education, will help in the early detection of visual impairment.